Effects of Lithium Therapy on Ventricular Repolarization in Bipolar Disorder Patients

Year 2018, Volume: 21 Issue: 3, 193 - 197, 02.12.2018

Cemil Zencir , Kadir Karakuş Oktay Kocabaş Gökhan Bahtiyar Mithat Selvi Kayıhan Karaman

Abstract

Introduction:
Bipolar disorder (BD) is a
significant mental health concern in the world. Most of the drugs used in the
treatment of bipolar disease may cause life-threatening arrhythmias by
affecting the distribution of ventricular repolarization (VR). VR is commonly
assessed using QT interval and Twave measurements. The aim of this study was to
evaluate VR using the T peak to T end (Tp-e) interval and the Tp-e/QT ratio and
to investigate the relationship between lithium therapy and VR parameters in
patients with BD.

Patients
and Methods: Forty-six BD
patients under lithium therapy and 45 participants in a control group were
included in our study. The Tp-e interval and Tp-e/QT ratio were measured using
12derivation electrocardiography (ECG). These parameters were compared between
groups.

Results:
The QT
interval (p= 0.01), QTc interval (p= 0.003), Tp-e interval (p< 0.001), and
Tpe/QT ratio (p= 0.009) were significantly higher in patients with BD than in
the control group. There was a positive correlation between the Tp-e interval
and serum lithium levels (r= 0.317, p< 0.032). In addition, the increased
serum lithium level (β= 0.398, p= 0.007) was found to be an independent
predictor of the prolonged Tp-e interval.

Conclusion:
Prolonged
Tp-e interval may be a useful indicator of increased risk of ventricular
arrhythmia in patients using lithium therapy.

Keywords

Bipolar disorder, lithium, Tp-e interval, ventricular repolarization

Bipolar Bozukluk Hastalarında Lityum Tedavisinin Ventriküler Repolarizasyon Üzerine Etkileri

Abstract

Giriş: Bipolar bozukluk (BD) dünyada önemli bir
mental sağlık sorununudur. Bipolar bozukluk tedavisinde kullanılan ilaçların
çoğu, ventriküler repolarizasyonun (VR) dağılımını etkileyerek hayatı tehdit
eden aritmilere neden olabilir. VR genellikle QT aralığı ve T dalgası ölçümleri
kullanılarak değerlendirilir. Bu çalışmanın amacı, Tp-e intervali ve Tp-e/QT
oranını kullanarak VR’yi değerlendirmek ve bipolar bozukluğu olan hastalarda
lityum tedavisi ve VR parametreleri arasındaki ilişkiyi araştırmaktır.

Hastalar ve
Yöntem: Çalışmamıza lityum tedavisi alan 46 hasta ve 45 katılımcıdan
oluşan kontrol grubu dahil edildi. Tp-e aralığı ve Tp-e/QT oranı 12-derivasyon
elektrokardiyografi (EKG) kullanılarak ölçüldü. Bu parametreler gruplar arasında
karşılaştırıldı.

Bulgular: Bipolar bozukluk olan hastalarda QT interval (p= 0.01),
QTc interval (p = 0.003), Tp-e interval (p< 0.001) ve Tp-e / QT oranı (p=
0.009) kontrol grubuna göre anlamlı olarak yüksek bulundu. Tp-e intervali ile
serum lityum düzeyleri arasında pozitif korelasyon vardı (r= 0.317, p<
0.032). Ayrıca artmış serum lityum seviyesi (β= 0.398, p= 0.007), uzun Tp-e
aralığının bağımsız bir belirleyicisi olarak bulundu.

Sonuç: Uzamış Tp-e intervali, lityum tedavisi kullanan hastalarda artmış
ventriküler aritmi riskinin yararlı bir göstergesi olabilir.

Keywords

Bipolar bozukluk, lityum, Tp-e interval, ventriküler repolarizasyon

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